Position Purpose:
Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.
Education/Experience:
Requires a High School diploma or GED
Requires 1 – 2 years of related experience
License/Certification:
For Florida-Sunshine Health Plan - All interactions with members are done telephonically
Provides outreach to members via phone to support with care plan next steps, community or health plan resources, questions or concerns related to scheduling and ongoing education for both the member and provider throughout care/service
Provides support to members to connect them to other health plan and community resources to ensure they are receiving high-quality customer care/service
May apply working knowledge of assigned health plan(s) activities and resources
Serves as the front-line support on various member and/or provider inquiries, requests, or concerns which may include explaining care plan procedures, and protocols
Supports member onboarding and day-to-day administrative duties including sending out welcome letters, related correspondence, and program educational materials to assist in the facilitation of a successful member/provider relationship
Documents and maintains non-clinical member records to ensure standards of practice and policies are in accordance with state and regulatory requirements and provide to providers as needed
Knowledge of existing benefits and resources locally and make referrals to address Social Determinants of Health (SDOH) needs
Performs other duties as assigned
Complies with all policies and standards
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
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Position Purpose:
Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling assessments. Serves as a point of contact to members, for scheduling purposes and documents member records in accordance with current state and regulatory guidelines.
Education/Experience:
Requires a High School diploma or GED
Requires 1 – 2 years of related experience
Complies with all policies and standards
Story Behind the Need
- What is the purpose of this team?
- Describe the surrounding team (team culture, work environment, etc.) & key projects.
- Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
Call center type role, making outbound and receiving inbound calls (daily goal of at least 30 members or more per day)
Speaking with members and legal representatives
Purpose of call: to schedule assessments for Star Kids Product (potentially Star Plus, Star Health, etc)
Supports administrative care management activities including performing outreach, answering inbound calls, and scheduling services. Serves as a point of contact to members, providers, and staff to resolve issues and documents member records in accordance with current state and regulatory guidelines.
Typical Day in the Role
- Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
- What are performance expectations/metrics?
What makes this role unique?
Performance expectations/metrics for this individual and their team:
Attendance is important, timeliness and professionalism necessary
30 members/day (attempting to schedule or scheduling them)
Strict turnaround time for this department – if not met, subject to potential damages by the state
Fast-paced environment and expected to follow up within a certain timeframe
Have experience in handling high call volume
Ability to multitask, members and system programs
First Day Details
May be required to attend a morning training by the IT team to set up equipment
Once activated in the system, connect with Supervisor and Team Lead
Provide an overview of what the team does. Go over rules/expectations.
Centene University training modules to complete compliance items
Training is in-house (completed by Scheduling Leadership and mentor schedulers) rather than with a set Centene trainer
Assigned lunch time and break times given
Candidate Requirements
Education/Certification
Required: HSD or equivalent
Preferred: n/a
Licensure
Required: n/a
Preferred: n/a
Years of experience required:
- Requires 1 – 2 years of related experience
Additional qualities to look for:
- Call center experience
- Computer knowledge such as Outlook, Excel
- Bilingual would be a preference but not a requirement
- Good customer services skills.
- Call center experience may benefit as we do outbound calls all day as well as receive inbound calls.
- Fast-paced environments, not just working at own pace in a doctor’s or medical office without being held to strict deadlines
- Home health or managed care experience was previously required, but we are willing to train on this and open a wider net for candidates like other managers in this area!
- Top 3 must-have hard skills stack-ranked by importance
1
High call volume experience. Need to be comfortable with this, does not necessarily need the experience previously.
2
Customer Service experience
3
Computer literate, good typing skills (send candidate typing test if you are concerned on this skill with a candidate) - Microsoft Office, Excel, Outlook experience required
Candidate Review & Selection
- Shortlisting process
- Candidate review & selection
- Interview information
- Onboard process and expectations
Projected Manager Candidate Review Date:
1-2 days post shortlisting
Type of Interviews:
Teams, phone, etc.
Required Testing or Assessment (by Vendor):
Typing test, basic computers skills test, etc.
Next Steps
